Questions and answers about the Lead replacements in plumbing products, lead and manganese update (June 2025) to the Australian Drinking Water Guidelines (the Guidelines).

About lead in drinking water

1. How does lead get into drinking water?

In Australia, public (or ‘town’) drinking water supplies are routinely monitored up to the point of supply (typically a water meter) and rarely contain lead above the Australian Drinking Water Guideline health-based guideline value.

Drinking water service providers are responsible for ensuring they treat water to remove lead present in the source water. However, lead can get into the treated drinking water when it comes into contact with plumbing products, such as copper alloys, that contain lead. When this occurs, the lead can leach out and dissolve into the water, posing a risk to public health.

In Australia, it is very rare to find drinking water service pipes containing lead. However, lead can be found in a range of plumbing products that are widely used in homes, buildings and water supply points such as drinking water fountains.

For information about lead in rainwater tanks, see Guidance on the use of rainwater tanks.

2. What are the health effects of being exposed to lead in drinking water?

Health effects as a result of lead exposure differ substantially between individuals. Factors such as a person’s age, the amount of lead, whether the exposure is over a short-term or a longer period, and the presence of other health conditions, will influence what symptoms or health effects are exhibited. Lead can be harmful to people of all ages, but the risk of health effects is highest for unborn babies, infants and children.  

Lead can be absorbed by the body through inhalation, ingestion or placental transfer. In adults, approximately 10% of ingested lead is absorbed, but in children this figure can be 4 to 5 times higher. After absorption, the lead is distributed in soft tissue such as the kidney, liver, and bone marrow where it has a biological half-life in adults of less than 40 days, and in skeletal bone where it can persist for 20 to 30 years.  

In humans, lead is a cumulative poison that can severely affect the central nervous system and is associated with numerous adverse effects. Young children, infants and unborn babies are most susceptible. Placental transfer of lead occurs in humans as early as the 12th week of gestation and continues throughout development.  

Several epidemiological studies have been carried out on the effects of lead exposure on neurodevelopmental and behavioural outcomes in children, suggesting that blood lead levels between 5 micrograms per decilitre (µg/dL) and 10 µg/dL can adversely affect intelligence in children (NHMRC 2015). In adults, a review found that there is jurisdictional agreement that key adverse effects associated with exposure to high amounts of lead include increased blood pressure and cardiovascular effects (SLR 2022). Recent studies have suggested that there is also moderate confidence in an association between lead exposure and increased fasting plasma glucose and incidence of fatty liver disease (Wan et al. 2021, 2022). The doses at which these effects occur are uncertain but appear to be at blood lead levels greater than 5 µg/dL (SLR 2022, 2023).  

Studies have investigated a wide range of other adverse effects associated with exposure to high amounts of lead in drinking water, including hip fractures (Dahl et al. 2014), kidney damage, interference with the production of red blood cells and measures of iron deficiency (Danziger et al. 2021, 2022). A number of studies have also investigated possible associations between lead exposure from drinking water and incidence of miscarriages and foetal death (Edwards et al. 2014), and the incidence of low birth weight and preterm births in American children (Dave and Yang 2022). However, the overall data for these studies is limited and no clear dose response relationships have been established (SLR 2023).

3. When is it necessary to have a blood test to determine blood lead levels?

Doctors should arrange a blood lead test if there is a particular reason to suspect that a person has been exposed to lead, for example:

  • If they have been involved in activities that may result in them swallowing, breathing in (inhaling) or touching lead or a substance that is contaminated with lead. Examples of these activities include the sanding of surfaces covered in old paint (such as, paint used before 1970) and where children have eaten dirt that may be contaminated with lead.
  • If someone else in their household has had a blood test that showed a level exceeding 5 µg/dL.
  • If they have signs or symptoms that are consistent with exposure to lead.
4. What does it mean if I have high blood lead levels?

If a person has a blood lead level greater than 5 µg/dL, this suggests that exposure has been, or continues to be, at a level above what is considered the ‘average’ background exposure in Australia. This exposure to lead should be investigated and reduced – particularly if the person is a child or pregnant woman, for example:

  • They (or their carer if they are a child) should be provided with information on how to identify the possible sources of lead exposure and how it can be reduced.
  • Public health officers, environmental health officers or those with expertise in exposure risk management may be required to investigate how and where the person is being exposed to lead, and remove the source if possible, or prevent contact with it.

If a blood test shows that a person’s blood lead level is between zero and 5 µg/dL (0.24 micromoles per litre), no particular action or treatment is needed.

More information can be found in the NHMRC Information Paper: Evidence on the Effects of Lead on Human Health.

5. When will the NHMRC Information Paper: Evidence on the Effects of Lead on Human Health be updated?

An update to the NHMRC advice and supporting materials on blood lead levels is not planned at this time and would require support and funding from the states and territories.

6. How can I find out if there is lead in my drinking water?

Drinking water can be tested to determine if it contains lead and to check the concentration relative to the Guideline value.  

In Australia, where drinking water is provided by regulated service providers, they are responsible for testing drinking water and ensuring it meets the Guideline value up to the point of supply to premises. Regulated service providers routinely conduct a range of tests to ensure drinking water supplied to premises complies with the Australian Drinking Water Guidelines and most publish drinking water reports on their websites. State and Territory governments regulate drinking water safety through their relevant health authorities and/or drinking water regulators.

Beyond a regulated service provider point of supply, or where water is sourced from a private drinking water supply, it is the responsibility of the building owner, manager or occupier to arrange testing.

If you need to arrange testing, sample collection and analysis should be carried out by a trained person, in line with accepted guidance, using National Association of Testing Authorities (NATA) accredited laboratories and with appropriate quality control samples.

7. What steps are being taken to reduce lead in drinking water?

NHMRC supports every effort to reduce the level of lead in drinking water in Australia. NHMRC has revised the health-based guideline value for lead in drinking water, lowering the health-based guideline value for lead in drinking water from 0.01 mg/L (endorsed 1996) to 0.005 mg/L.

There are a number of additional regulatory measures already in place in Australia to preventatively manage health risks associated with chemicals leaching from plumbing products and to help ensure water at the tap is safe. For example, from 1 May 2026, all new plumbing installations conveying drinking water are required to use products that are compliant with the lead free requirements of the National Construction Code (NCC), Volume Three – Plumbing Code of Australia 2022.

About lead replacements in plumbing products

8. What are lead free plumbing products?

Lead has traditionally been added to the copper alloy in order to improve the products malleability and machinability. Whilst those lead levels supported compliance with the Australian Drinking Water Guidelines, the Australian Building Codes Board (ABCB) has revised the Plumbing Code of Australia 2022 to limit the allowable lead content and require that copper alloy plumbing products used to convey drinking water are Lead Free WaterMark certified from 1 May 2026.

The term ‘lead free’ is defined in the Plumbing Code of Australia 2022 as ‘where a plumbing product or material in contact with drinking water has a weighted average lead content of not more than 0.25%’. This definition aligns the Plumbing Code of Australia 2022 with the United States Safe Drinking Water Act and other international codes.

It is anticipated that the widespread use of lead free plumbing products can have a measurable impact in reducing lead exposure from drinking water and blood lead levels of the Australian public.

9. Will chemicals used to replace lead in plumbing products leach into drinking water?

While lead free plumbing products will reduce the leaching of lead into drinking water and thus the risk of exposure to lead, it is important to confirm that any chemicals used to replace lead in plumbing products do not leach into water at unsafe levels.

Several copper alloy formulations (bismuth, selenium and silicon) have been identified as potential lead replacements in plumbing products. A review of the existing evidence for these formulations found little to no data to quantify the nature or levels of chemicals that may leach into drinking water from these copper alloys, whether in distribution systems or within in-premises (i.e. beyond the water meter). More information is needed on the forms of bismuth, selenium or silicon in water and leachates as well as potential exposure concentrations.

As new information and data on the types and composition of plumbing products becomes available, guidance around the potential risks to health from chemicals leaching from plumbing products can be refined and updated.

10. What can be done to reduce exposure to chemicals leaching from plumbing products?

A number of regulatory measures exist in Australia to reduce exposure to chemicals leaching from plumbing products, and to ensure water at the tap is safe.

  • Use plumbing products that are safe for use in drinking water and look for the Lead Free WaterMark trademark. From 1 May 2026, all new plumbing installations conveying drinking water are required to use products that are compliant with the lead free requirements of the Plumbing Code of Australia (ABCB 2022).
  • Preventative flushing regimes can be utilised in the absence of in-premises water treatment options. These can reduce potential exposure to chemicals that may leach from plumbing products in households and other buildings such as schools, preschools and childcare centres. For further information, see Environmental Health Standing Committee (enHealth) Guidance – Reducing exposure to metals in drinking water from plumbing products.
  • Where needed, in-premises water treatment units, such as filtration or reverse osmosis units, may be effective at removing chemicals from drinking water in plumbing systems.

See Section 9.6 of the Australian Drinking Water Guidelines for further information on exposure reduction.

11. Is there a health risk from exposure to these chemicals in drinking water?

While exposure to elevated levels of some chemicals that may leach from plumbing products may pose a health risk, concentrations of these chemicals in Australian reticulated drinking water supplies are likely to be lower than the health-based guideline values set for each chemical.

As explained above, there are various measures that exist to manage the health risks associated with plumbing products such as flushing and in-premises water treatment.

12. What is a health-based guideline value for drinking water?

Health-based guideline values indicate the amount of a chemical in drinking water that a person can consume on a daily basis over a lifetime without any appreciable risk to health. The Australian Drinking Water Guidelines are protective of human health and take into account Australia’s conditions and context. The health-based guideline values are very conservative, and include a range of uncertainty factors, which always err on the side of caution.

See Chapter 6 of the Australian Drinking Water Guidelines for further information on how guideline values are calculated.

13. What is an aesthetic-based guideline value for drinking water?

Aesthetic-based guideline values represent the concentration or measure of a water quality characteristic that is associated with consumer acceptability of drinking water. These guideline values are set to ensure drinking water is aesthetically pleasing, with the appearance, taste and odour of the water considered.

As the setting of an aesthetic-based guideline value may depend on public expectations, values can be determined by water authorities in consultation with consumers, considering the costs and benefits of further treatment of the water.

See Chapter 1.3 of the Australian Drinking Water Guidelines for further information on water quality characteristics.

14. How does this impact on plumbing practitioners?

The WaterMark Schedule of Products outlines all plumbing products which require WaterMark certification to be authorised for installation in a plumbing or drainage system. The Schedule also identifies which products must comply with the lead free requirements of Plumbing Code of Australia 2022.

From 1 May 2023, a 3-year transition period commenced for identified products to be manufactured to meet the lead free requirements. During this transition period products may be supplied to the market with the Lead Free WaterMark trademark, however, it will not be mandatory to use the lead free versions of identified products until 1 May 2026. This means plumbing practitioners may continue to install existing products, as well as those manufactured as lead free, providing the products have current WaterMark certification.

However, from 1 May 2026 only lead free versions of identified products will be authorised for use in plumbing systems used to convey drinking water. From this date plumbing practitioners will need to look for the Lead Free WaterMark trademark on a plumbing product to ensure the product being purchased or installed is authorised for use in contact with drinking water.

About manganese in drinking water

15. Why has a review of manganese been included in this revision?

In mid-2023, public health authorities in the Northern Territory requested a review of the health-based guideline value for manganese in drinking water following reported exceedances of manganese in the drinking water of remote communities in the Northern Territory. Several international reviews had been published examining the potential toxicity of manganese in drinking water, and based on the outcomes of these reviews, lower drinking water guideline values had been implemented by other public health authorities (Health Canada 2019, WHO 2022). The review of manganese in drinking water was prioritised by the Committee and the enHealth Water Quality Expert Reference Panel at meetings held between July and December 2023. An evidence review of recent guidance/guidelines on manganese was undertaken by NHMRC in late 2023 – early 2024.

16. How does manganese get into drinking water?

Manganese is a mineral that is found naturally in the environment and can be found in both groundwater and surface water from natural sources or as a result of human activity such as mining and industrial discharges. Manganese is used in plumbing material manufacturing and its presence is often associated with cast iron installations. It can leach from plumbing fittings into a domestic supply. Manganese can be found naturally in many foods at varying concentrations. High concentrations (up to 5 mg/100 g) may be found in nuts, tea leaves, legumes, grains and some fruits. Manganese may also be used as a plant fertiliser (micronutrient for plants).

Manganese concentrations in distributed drinking water across Australia are typically less than 0.3 mg/L. However, certain regions in Australia (for example, regional Northern Territory) have detected high manganese concentrations in distributed drinking water that exceed the recommended aesthetic and health-based guideline values.

17. What are the health effects of being exposed to manganese in drinking water?

Manganese is an essential trace element required for normal growth and development in humans (including development of the nervous system and brain), especially in early life. However, once manganese doses exceed recommended guideline values, studies suggest an association between exposure to manganese in drinking water and neurological effects (for example, intellectual impairment and poorer neurobehavioral function, including memory, attention, motor function and hyperactivity).

Infants, especially newborns, are more susceptible than other age groups to the neurotoxic effects of excess manganese.

18. How can I find out if there is manganese in my drinking water?

Manganese concentrations in distributed drinking water across Australia are typically low. Excess manganese in drinking water may taste bad and stain plumbing fixtures and laundry.

The responsibility for testing drinking water in Australia depends on whether the water comes from a regulated public (or 'town') water supply versus a private supply such as a rainwater tank or private bore.

For regulated supplies, drinking water providers are responsible for testing public drinking water in Australia. In consultation with state and territory drinking water regulators, water utilities apply a preventative risk-based approach to the management of drinking water quality. Water utilities routinely conduct a range of tests to ensure drinking water quality complies with the Australian Drinking Water Guidelines and most publish reports on their website.

The responsibility for testing private drinking water supplies, such as rainwater tanks or private bores, lies with the owner of the property and it is up to them to test and ensure the safety of their own water supply.

About the guidance

19. Why has NHMRC developed this guidance material?

Since the Australian Drinking Water Guidelines were published in 2011, NHMRC maintains the Guidelines through a rolling review process to ensure they represent the latest scientific evidence on good quality drinking water. Updates to specific sections are prioritised based on new or emerging scientific evidence, stakeholder needs and available resources. These prioritised updates are delivered with expert advice from the Water Quality Advisory Committee (the Committee).

Prioritised chemicals (including lead and selenium):

NHMRC engaged with previous terms of the Committee to prioritise work on a number of chemical fact sheets in the Guidelines. This work was achieved with the development and utilisation of screening criteria that identified chemicals as priority. With the expert advice of the Committee, and in consultation with the enHealth Water Quality Expert Reference Panel, a number of priority chemicals were agreed on for review. These included lead and selenium.

Lead replacements in copper alloy plumbing products (bismuth, selenium, silicon):

In July 2021, the Australian Building Codes Board (ABCB) determined to limit the lead content of plumbing products in contact with drinking water to 0.25% (ABCB 2021, 2023). The Decision Regulation Impact Statement recommended work be undertaken with health authorities on what limits should be placed, if any, on the use of lead substitutes. This change in regulation was proposed in response to building pressure from health agencies, including NHMRC, to improve public health outcomes in relation to lead in drinking water.

In preparation for these upcoming changes in regulation, NHMRC met with ABCB and enHealth in 2021 to discuss the available data, timeframes and NHMRC processes required to develop public health advice for the Guidelines. Following this, enHealth requested that NHMRC prioritise a review of the health evidence for proposed lead replacements in plumbing products such as bismuth, selenium and silicon copper alloys and to develop public health advice for these and any future lead replacements that might appear on the market.

Manganese:

A review of the health-based guideline value for manganese in drinking water was requested by public health authorities in 2023. This was requested following exceedances of manganese in the drinking water of remote communities in the Northen Territory.

The review of manganese in drinking water was subsequently prioritised by the Committee and the enHealth Water Quality Expert Reference Panel in meetings held in late 2023.

20. How was this guidance material developed?

Prioritised chemicals (including lead and selenium) and lead replacements in plumbing products:

In separate tender processes in 2021 and 2022, NHMRC contracted SLR Consulting Australia to conduct independent reviews of existing guidance/guidelines for potential adopt/adapt in Australia for priority chemicals (lead and selenium) and the selected lead replacements in plumbing products (bismuth and silicon and their copper alloys).

The first stage review of lead and selenium showed that although there were suitable candidate health-based guidance values for both chemicals that could be adopted/adapted to the Australian context, a substantial body of evidence had been published that had not been taken into consideration. An extended review of the recent literature was recommended and subsequently conducted to support the update of the lead and selenium fact sheets.

No existing drinking water guidelines for potential adoption/adaptation were found for bismuth and silicon and their copper alloys. A full review of primary literature was conducted.

The results of these reports were considered by NHMRC and the Committee and used, via an evidence-to-decision process, to inform the update and development of information and chemical fact sheets.

Manganese:

An evidence review of recent guidance/guidelines on manganese was undertaken by NHMRC in late 2023 - early 2024. The review did not make recommendations for health-based or aesthetic guideline values but provided candidate guideline options for consideration by the Committee. These options were based on existing guidance/guidelines that were found suitable to adopt/adapt to the Australian context, with a critical discussion of the underlying key toxicological studies used by each agency to derive their guidance/guidelines.

An evidence-to-decision process was used to inform the update of the chemical fact sheet.

21. How did NHMRC review the evidence to derive the guideline values?

NHMRC has designed a streamlined methodological framework to guide the rolling revision of chemical fact sheets in the Australian Drinking Water Guidelines. The methodological framework ensures consistency and alignment with the 2016 NHMRC Standards for Guidelines and international best practice, whilst making efficient use of limited project resources and time.

The methodological framework outlines a staged approach involving a transparent adopt/adapt process for evaluating existing health advice (such as recent international health-based guideline values) in the first instance instead of undertaking a full review of primary studies. This is to reduce duplication of effort, and the time needed to review the fact sheets, as many recent reviews undertaken by overseas agencies are available.

Existing guidance for a chemical may not always be available or appropriate to use for the Australian context. In these cases, a full review of recent primary studies is required, and additional resources will be needed to undertake the review.

22. Who was involved in developing this advice?

The rolling revision of the Australian Drinking Water Guidelines is overseen by the NHMRC Water Quality Advisory Committee which provides expertise in the fields of microbiology, toxicology, water quality risk assessment and management, water chemistry and recycling, groundwater hydrology, guidelines and methodology. Jurisdictional representatives with knowledge of implementing the Guidelines are also members. The Committee has observer members from the National Indigenous Australians Agency, the Australian Department of Climate Change, Energy, the Environment and Water, and the Australian Industrial Chemicals Introduction Scheme.

This Committee provides expert advice to the NHMRC Council on the public health aspects of water quality and priority issues.

NHMRC consulted the enHealth Water Quality Expert Reference Panel regarding the proposed amendments and corrections before seeking advice from the Council of NHMRC. 

NHMRC also undertook a public consultation on the proposed amendments.

More details of the development of the advice are provided in the Administrative Report for this update.

23. Who will use this guidance?

The guidance is intended to form an update to the Australian Drinking Water Guidelines. The Guidelines are used by all agencies involved in the supply of drinking water, for example state and territory health departments and drinking water regulators, local health authorities and water utilities.

24. What does the guidance material recommend?

The draft guidance material includes a new information sheet on metals and metalloids leaching from plumbing products, new health-based guideline values for bismuth and silicon in drinking water, and changes to the guidelines for silica, selenium, lead and manganese in drinking water.

There are also minor edits across the Australian Drinking Water Guidelines to provide alignment and consistency between sections.

Bismuth fact sheet:

  • Previous guideline recommendation: No fact sheet on bismuth in the Guidelines.
  • Updated guideline recommendation: Based on health considerations, the concentration of bismuth in drinking water should not exceed 10 mg/L.

Silicon and silica fact sheet:

  • Previous guideline recommendations: No fact sheet on silicon in the Guidelines.
    To minimise an undesirable scale build up on surfaces, silica (SiO2) within drinking waters should not exceed 80 mg/L.
  • Updated guideline recommendations: Based on health considerations, the concentration of silicon in drinking water should not exceed 100 mg Si/L (equivalent to 210 mg SiO2/L).
    To minimise an undesirable scale build up on surfaces, the aesthetic value for silica in drinking water should not exceed 80 mg SiO2/L (equivalent to 37 mg Si/L).

Selenium fact sheet:

  • Previous guideline recommendation: Based on health considerations, the concentration of selenium in drinking water should not exceed 0.01 mg/L.
  • Updated guideline recommendation: Based on health considerations, the concentration of selenium in drinking water should not exceed 0.004 mg/L.

Lead fact sheet:

  • Previous guideline recommendation: Based on health considerations, the concentration of lead in drinking water should not exceed 0.01 mg/L.
  • Updated guideline recommendation: Based on health considerations the concentration of lead in drinking water should not exceed 0.005 mg/L.

Manganese fact sheet:

  • Previous guideline recommendations: Based on aesthetic considerations, the concentration of manganese in drinking water should not exceed 0.1 mg/L.
    Based on health considerations, the concentration of manganese in drinking water should not exceed 0.5 mg/L.
  • Updated guideline recommendations: Based on aesthetic considerations, the concentration of manganese in drinking water should not exceed 0.05 mg/L, measured at the customer’s tap. Water authorities are encouraged to keep manganese concentrations as low as possible, preferably below 0.02 mg/L at the treatment plant.
    Based on health considerations the concentration of manganese in drinking water should not exceed 0.1 mg/L.
25. Why has the silicon and silica fact sheet been combined?

Following feedback from public consultation, the proposed new silicon and existing silica fact sheets were combined due to the overlap in references between the 2 chemicals and most studies used a measurement of silica converted to silicon by calculation.  A combined fact sheet was recommended by stakeholders.

26. Will the guidance apply to water at the tap?

The guideline values relate to the quality of water at the point of use (for example, kitchen or bathroom tap). They apply to reticulated water at the consumer’s tap, rainwater for drinking, and source water if it is to be used without prior treatment. As the leaching of chemicals from plumbing products commonly occurs past the point of water supply (for instance, the water meter), in networks contained within in-premises, this does not imply that the drinking water supplier is responsible for water quality problems caused by plumbing or other factors within a consumer’s property.

The correct and compliant installation and management of plumbing products and systems within buildings is the responsibility of building owners or managers. If there are concerns over in-premises drinking water, such as metallic taste or discolouration of water, a sampling program to test for metals may be necessary.

See enHealth Guidance – Reducing exposure to metals in drinking water from plumbing products and Lead in drinking water from some plumbing products for further information.

27. Are these guidelines protective of sensitive groups?

The Australian Drinking Water Guidelines are derived to take account of the needs of an individual through a normal lifetime, including changes in sensitivity that may occur between life stages. The Guidelines are considered protective of sensitive sub-populations such as infants and young children, people who are chronically unwell or whose health is impacted by poor living conditions, and the elderly.

Health-based guideline values for lead and manganese are set to minimise exposure in bottle-fed infants (0 to 2 years), as infants and young children are the most susceptible to the neurotoxic effects of excess lead and manganese exposure.

28. Given that the health-based guideline values for lead and manganese were set to minimise exposure in bottle-fed infants (0 to 2 years), are these guidelines considered acute?

The health-based guideline values for lead and manganese protect the health of children and those most vulnerable. The terms ‘acute’ and ‘chronic’ do not translate well in the context of toxicants that target a sensitive period of development. In that context, even an ‘acute’ exposure has ‘chronic’ consequences.

While these chemicals also impact on adults, the health-based guideline values for lead and manganese are set for the most sensitive population groups, which will be protective for the rest of the population.

29. Are NHMRC advice and guideline recommendations mandatory?

No, but states and territories may reference or adopt them in their relevant legislation.

The role of NHMRC, as set out in Section 7 of the National Health and Medical Research Council Act 1992, is to inquire into, issue guidelines on, and advise on public health matters. 

The Australian Drinking Water Guidelines provide an authoritative reference of what constitutes safe drinking water at the point of human consumption and are underpinned by a risk management framework that encourages site-specific planning for monitoring and treatment based on local conditions.

The Guidelines are adopted or referenced by various levels of government to develop policy, and these government departments have the responsibility to implement and monitor these policies. Management of drinking water depends on the legislated arrangements for water supply within each jurisdiction; for example, in some states, water supply is managed by the one water corporation, whereas in other states it is managed locally by numerous water suppliers. The relevant state/territory health and/or drinking water regulator is responsible for regulating supply and establishing monitoring requirements.

30. Where can I find more information?

Further information can be found in the supporting information for this review.

 

References

ABCB (2021). Lead in plumbing products in contact with drinking water. Final Regulation Impact Statement 2021, published by the Australian Building Codes Board https://www.abcb.gov.au/sites/default/files/resources/2022/Lead-in-plumbing-products-final-RIS-20210517.pdf.

ABCB (2022). National Construction Code 2022 Volume 3 – Plumbing Code of Australia. Commonwealth of Australia and the States and Territories 2022, published by the Australian Building Codes Board https://ncc.abcb.gov.au/editions/ncc-2022/adopted/volume-three.

ABCB (2023). WaterMark Certification Scheme – Notice of Direction 2022/1.1: Acceptable copper alloys for the manufacture of Lead Free plumbing products, published by the Australian Building Codes Board www.abcb.gov.au/sites/default/files/resources/2023/2022-1.1-NoD-Acceptable-copper-alloys-for-lead-free-plumbing-products.pdf.

Dahl C, Søgaard AJ, Tell GS, Flaten TP, Hongve D, Omsland TK, Holvik K, Meyer HE and Aamodt G (2014). Do cadmium, lead, and aluminum in drinking water increase the risk of hip fractures? A NOREPOS study. Biol Trace Elem Res 157(1): 14-23.

Danziger J, Mukamal KJ and Weinhandl E (2021). Associations of Community Water Lead Concentrations with Hemoglobin Concentrations and Erythropoietin-Stimulating Agent Use among Patients with Advanced CKD. J Am Soc Nephrol 32(10): 2425-2434.

Danziger J and Mukamal KJ (2022). Levels of Lead in Residential Drinking Water and Iron Deficiency among Patients with End Stage Kidney Disease. Kidney360 3(7): 1210-1216.

Dave DM and Yang M (2022). Lead in drinking water and birth outcomes: A tale of two water treatment plants. J Health Econ 84: 102644.

Edwards M (2014). Fetal death and reduced birth rates associated with exposure to lead-contaminated drinking water. Environ Sci Technol 48(1): 739-746.

enHealth (2010) enHealth Guidance Statement: Guidance on the use of rainwater tanks, published by Environmental Health Standing Committee www.health.gov.au/resources/publications/enhealth-guidance-guidance-on-the-use-of-rainwater-tanks.

enHealth (2021) enHealth Guidance: Reducing exposure to metals in drinking water from plumbing products, published by Environmental Health Standing Committee www.health.gov.au/resources/publications/enhealth-guidance-reducing-exposure-to-metals-in-drinking-water-from-plumbing-products.  

enHealth (2021) enHealth Guidance Statement: Lead in drinking water from some plumbing products, published by Environmental Health Standing Committee, www.health.gov.au/resources/publications/enhealth-guidance-lead-in-drinking-water-from-some-plumbing-products.

Government of Canada. (2019) Guidelines for Canadian Drinking Water Quality: Guideline Technical Document – Manganese, published by Health Canada www.canada.ca/en/health-canada/services/publications/healthy-living/guidelines-canadian-drinking-water-quality-guideline-technical-document-manganese.

NHMRC (2015) Evidence on the effects of lead on human health, published on NHMRC website https://www.nhmrc.gov.au/about-us/publications/evidence-effects-lead-human-health.

SLR (2022). Evidence Evaluations for Australian Drinking Water Guideline Chemical Fact Sheets –Lead Evaluation Report. SLR Consulting Australia Pty Ltd. Report prepared for the National Health and Medical Research Council, May 2022.  

SLR (2023). Evidence Evaluations for Australian Drinking Water Guidelines Chemical Fact Sheets – Lead Replacements in Plumbing – Lead Evaluation Report. SLR Consulting Australia Pty Ltd. Report prepared for the National Health and Medical Research Council, November 2023.

Wan H, Wang B, Cui Y, Wang Y, Zhang K, Chen C, Xia F, Ye L, Wang L, Wang N, and Lu Y (2021). Low-level lead exposure promotes hepatic gluconeogenesis and contributes to the elevation of fasting glucose level. Chemosphere, 276: 130111.

Wan H, Wang Y, Zhang H, Zhang K, Chen Y, Chen C, Zhang W, Xia F, Wang N and Lu Y (2022). Chronic lead exposure induces fatty liver disease associated with the variations of gut microbiota. Ecotoxicol Environ Saf 232: 113257.

WHO (2022) Guidelines for drinking-water Quality, fourth edition, published by WHO www.who.int/publications/m/item/chemical-fact-sheets--manganese.